Abstract:
:There is a high risk of anastomotic leakage following pancreaticojejunostomy after pancreaticoduodenectomy or middle pancreatectomy in patients with a normal soft pancreas because of the abundant exocrine function. Therefore, pancreaticojejunostomy is generally performed using a stent tube (stented method). However, pancreaticojejunostomy with a certain duct-to-mucosa anastomosis does not always require a stent tube even in patients with a normal soft pancreas. We have performed pancreaticojejunostomy with duct-to-mucosa anastomosis without a stent tube (nonstented method) and obtained good results. The objective of this technique is to maintain adequate patency of the anastomosis using a fine atraumatic needle and monofilament suture. The pancreas, including the pancreatic duct, is sharply transected with a scalpel. Any arterial bleeding points on the pancreatic cut end are repaired with fine nonabsorbable sutures. The end-to-side anastomosis between the pancreas and jejunum consists of two layers of sutures. The outer layer is composed of the capsular parenchyma of the pancreas and the jejunal seromuscularis, and the inner layer is composed of the pancreatic duct with an adequate pancreatic parenchyma and the whole jejunal wall. Complete pancreaticojejunostomy using duct-to-mucosa anastomosis does not require a stent tube. This nonstented method can be considered one of the basic procedures for pancreaticojejunostomy because of its safety and reliability.
journal_name
J Hepatobiliary Pancreat Scijournal_title
Journal of hepato-biliary-pancreatic sciencesauthors
Hatori Tdoi
10.1007/s00534-011-0470-xsubject
Has Abstractpub_date
2012-03-01 00:00:00pages
125-30issue
2eissn
1868-6974issn
1868-6982journal_volume
19pub_type
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